Hides Julie A, Miokovic Tanja, Belavý Daniel L, Stanton Warren R, Richardson Carolyn A
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
J Orthop Sports Phys Ther. 2007 Aug;37(8):480-6. doi: 10.2519/jospt.2007.2416.
Test-retest intrarater reliability study.
To examine reliability of abdominal musculature measurements across a broad range of conditions for a physical therapist newly trained in assessment using rehabilitative ultrasound imaging (RUSI).
RUSI has previously been used to assess abdominal muscle function during a drawing-in maneuver of the anterior abdominal wall, and measurements conducted by an experienced assessor have been validated by comparison with magnetic resonance imaging. Few studies have examined the reliability of less experienced operators, and only in isolated measurement conditions.
Nineteen subjects (11 female, 8 male) without a history of low back pain performed the abdominal drawing-in maneuver in a supine hook-lying position. RUSI was used bilaterally to assess the thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles at rest and on contraction, as well as changes in the length of the TrA muscle (indicated by slide of the anterior abdominal fascia). The reliability of a novice rater who received 8 hours of training was examined (a) across 3 measurements of the same ultrasound image, (b) across 3 separate ultrasound images (averaged for days and sides of abdomen), and (c) across 2 days (averaged for images and sides).
Reliability of assessing muscle thickness was very high across 3 measurements of the sale image (intrarater correlation coefficients [ICC3.1] were all greater than 0.97), fair to high across 3 images (ICC(3,4) = 0.62-0.82), and fair to high across 2 days (ICC(3,6) = 0.63-0.85). Reliability of measuring the slide of the anterior abdominal fascia was very high across measurements from the same image (ICC(3,1) = 0.98) but very low across images (ICC(3,4) = 0.44) and across 2 days (ICC(3,6) = 0.36).
High reliability of a novice rater was demonstrated for some measurement conditions. Measures of reliability for recapturing the image and repetition across days ranged from low to high. Inconsistencies in the pattern of results suggest that for a novice assessor using RUSI, training should be performed and reliability assessed for each abdominal muscle and measurement condition intended to be used for research and clinical practice.
重测法评估同一评估者内部信效度。
对于一名刚接受使用康复超声成像（RUSI）进行评估培训的物理治疗师，检验在广泛条件下腹部肌肉组织测量的信效度。
RUSI先前已用于评估前腹壁吸气动作时的腹部肌肉功能，且经验丰富的评估者所做测量已通过与磁共振成像对比得到验证。很少有研究检验经验不足的操作者的信效度，且仅在孤立的测量条件下进行。
19名无腰痛病史的受试者（11名女性，8名男性）在仰卧位钩状卧位下进行腹部吸气动作。双侧使用RUSI评估静息和收缩时腹内斜肌（IO）和腹横肌（TrA）的厚度，以及TrA肌长度的变化（以前腹壁筋膜滑动表示）。检验接受8小时培训的新手评估者的信效度：（a）对同一超声图像进行3次测量；（b）对3张单独的超声图像（按腹部天数和两侧平均）；（c）在2天内（按图像和两侧平均）。
对同一图像进行3次测量时，评估肌肉厚度的信效度非常高（同一评估者相关系数[ICC3.1]均大于0.97），对3张图像的信效度为中等至高（ICC(3,4)=0.62 - 0.82），在2天内的信效度为中等至高（ICC(3,6)=0.63 - 0.85）。测量前腹壁筋膜滑动时，对同一图像测量的信效度非常高（ICC(3,1)=0.98），但对图像间（ICC(3,4)=0.44）和2天内（ICC(3,6)=0.36）的信效度非常低。
在某些测量条件下，新手评估者表现出较高的信效度。重新获取图像和跨天重复测量的信效度范围从低到高。结果模式的不一致表明，对于使用RUSI的新手评估者，应针对拟用于研究和临床实践的每块腹部肌肉及测量条件进行培训并评估信效度。
